Domonique Jones Goode

Individual provider Active NPI Counselor · Kingstree, SC

NPI 1508202797 · NPPES record last updated May 15, 2013

Key facts

NPI
1508202797
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
1503 Woodland Dr
Kingstree, SC 29556-2123
Phone
(843) 355-7233
NPI assigned
May 15, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Yes

Addresses

Primary practice location

1503 Woodland Dr
Kingstree, SC 29556-2123

Mailing address

1503 Woodland Dr
Kingstree, SC 29556-2123
Phone (843) 355-7233

Other providers in Kingstree, SC

All providers in Kingstree, SC · Counselor in South Carolina

Sources for this page

Verify at the official NPI Registry.